Migration health research in the United Kingdom: A scoping review

Abstract

Background: One in seven people living in the United Kingdom (UK) is an international migrant, rendering migrants an important population group with diverse and dynamic health and healthcare needs. However, there has been no attempt to map contemporary trends within migration health research conducted in the UK. The aim of this scoping review was to describe trends within migration health research and identify gaps for future research agendas.

Methods: PubMed and Embase were systematically searched for empirical research with a primary focus on the concepts "health" and "migrants" published between 2001 and 2019. Findings were analysed using the UCL-Lancet Commission on Migration and Health Conceptual Framework for Migration and Health.

Results: In total, 399 studies were included, with almost half (41.1%; 164/399) published in the last five years of the study period between 2015 and 2019 and a third (34.1%; 136/399) conducted in London. Studies included asylum seekers (14.8%; 59/399), refugees (12.3%; 49/399), and undocumented migrants or migrants with insecure status (3.5%; 14/399), but most articles (74.9%; 299/399) did not specify a migrant sub-group. The most studied health topics were specific disease outcomes such as infectious diseases (24.1% of studies) and mental health (19.1%) compared to examining systems or structures that impact health (27.8%), access to healthcare (26.3%), or specific exposures or behaviours (35.3%).

Conclusions: There has been a growing interest in migration health. Ensuring a diverse geographic distribution of research conducted in the UK and disaggregation by migrant sub-group is required for a nuanced and region-specific understanding of specific health needs, interventions and appropriate service delivery for different migrant populations. More research is needed to understand how migration policy and legislation intersect with both the social determinants of health and access to healthcare to shape the health of migrants in the UK.

Keywords: EU, European Union; HIV, Human immunodeficiency virus; Health; ICD-10, International Classification of Diseases - Tenth Revision; Migrant; Migration; NHS, National Health Service; ONS, Office of National Statistics; PTSD, Post-traumatic stress disorder; SMR, Standardised mortality ratio; Scoping review; TB, Tuberculosis; UCL, University College London; United Kingdom.

Fig. 1

Four domains (green boxes) adapted from the UCL-Lancet Commission Conceptual Framework of Migration and Health. Blue arrows represent the migration-related influences from place of origin or home. Purple arrows represent migration-related influences that emerge or change at a transit stage and/or in the destination. Health topics for this study were only assessed in the UK as the destination country.

Fig. 2

Study selection.

Fig. 3

Migration health research publications in the UK between 2001 and 2019. Migrant population size as a percentage of the total UK population is marked in the blue line.

Fig. 4

Comparison of the top ten rank position of migrant country of origin when ordering by number of articles and ONS average population size between 2001 - 2019. Blue lines correspond to a higher rank position in the number of articles compared to population size. Red lines correspond to a lower rank position when ordering by the number of articles compared to population size.

Fig. 5

Number of articles with at least one outcome in each of the four domains. Note: Studies often included outcomes in more than one domain.

Fig. 6

Top 5 health outcomes within each domain. Note that panel D has a different x-axis scale to panels A - C.

Fig. 7

Top 5 infectious disease (A) and mental health (B) outcomes in terms of number of articles. Note that the outcome of mental health in 7B is a general measure of mental health.

Fig. 8

Treemap of studies included by ICD-10 group and summary SMR. Area represents the number of studies in each ICD-10 category. Colour corresponds to previously published SMRs specific to migrants for each ICD-10 category.